Highly motivated and hard working professional committed to providing positive outcomes.
Revenue Cycle Management
Training and Management Information System
Excellent organizational skills
Excellent critical thinking skills
Able to multi-task
Initiated Pennsylvania transition of AS/400 into MyAvatar which resulted in our enabling our clinicians to input notes electronically, advanced billing software package, decrease in claim rejection and increase in revenue.
Complete analysis of Northeast Revenue Cycle Management Department using a SWOT analysis. Implemented a process improvement plan which included steps to improve staff retention, update policies and procedures and ensure consistent revenue flow.
Revenue Cycle Management Children's Behavioral Health, IncJohnstown, PennsylvaniaNortheast Regional Director
Ensuring the efficient operation of the AS/400 Management Information System and other software applications as they relate to all aspect of the claims life span for three companies.
Responsible for setting up new programs in electronic medical records system (Avatar).
Duties include setting up programs including services codes, guarantors, and general ledger mapping.
Lines of business include outpatient mental health clinics, children's partial hospitalization, family based clinics, behavioral health rehabilitative services, crisis residential, behavior support systems, and intellectual disabilities program which includes day treatment and residential.
Supervising a team consisting of one medical biller/follow-up specialist supervisor, three cash posters, two authorization/utilization management specialist, and eight medical biller/follow up specialist.
The goal is to ensure assigned job tasks are done in accordance with acceptable billing procedures, company policies and procedures, and government regulations.
Follow through on compliance mandates regarding improper billed services and ensure payers receive reimbursement.
Generation of semimonthly and monthly reporting for upper management's review and reporting.
Creation of accounts receivables spreadsheet summarizing monthly changes in accounts receivables aging to identify positive and negative trends.
Communication with payers and attendance at meetings to facilitate and maintain a billing mechanism which operates without interruption in an efficient organized manner.
Nulton Diagnostic and Treatment CenterJohnstown, PennsylvaniaDirector of Billing
Implementation of Medisoft billing software to enhance the business operations.
Ensured a constant flow of revenue into the company.
Responsible for managing the day-to-day operations of the billing department.
Supervised a team four medical billers, cash posters, and follow up personnel.
Lines of business included outpatient mental health clinics, children's partial hospitalization, family based clinics, and behavioral health rehabilitative services.
Credentialing with third-party payers to provide behavioral health services to their members.
Highmark Blue Cross Blue ShieldJohnstown, PennsylvaniaSecretary
Responsible for providing administrative support to the Clinical Consultants and Manager.
Developed internal and external training programs for Clinical Consulting Services.
Coordinated monthly calendar and development of database to track Clinical Consultants physician visits and training.
Conducted research thru ICS and ROAR mainframe to solve physician issues.
Trained new staff in the various computer software packages and telephone system.
Worked with Sales/Marketing Department and Member Services to resolve issues and ensure open communication.